Arthrotomography of the wrist: an experimental and preliminary clinical study

Experimental arthrotomography including posteroanterior and lateral projections was completed in 18 fresh-frozen wrists from cadavers with an average age of 65 years at death. Arthrotomographic findings were correlated with anatomic dissections. Three types of defects of the triangular fibrocartilage complex were clearly defined in 38% of wrists. Chondromalacia was present in 24% of wrists, in all cases on the ulnar half of the proximal surface of the lunate bone. The palmar radiocarpal ligaments (radiocapitate and radiotriquetral) were visible in all specimens. Experimental arthrotomography appears to be useful in defining the nature and location of soft tissue pathology in clinical practice. Clinical arthrotomography was performed in 16 patients, all with a syndrome of chronic wrist pain. Pathologic findings were observed in 11 wrists, including four perforations of the triangular fibrocartilage complex, two cases of chondromalacia of the lunate, one tear in each of the scapholunate and lunotriquetral ligaments, three occult palmar ganglia, and one recurrent dorsal ganglion. The soft tissues in five wrists were normal. The preliminary clinical experience with wrist arthrotomography has yielded results that have significantly affected the care of patients, including the planning of operative treatment and patient counseling.     

Echocardiographic study of 4 cases of dilatation of the sinus of Valsalva]

Four cases of dilatation of the sinus of Valsalva with or without rupture were studied by echocardiography before surgical correction. In three cases the dilatation affected the right anterior sinus with rupture into the right atrium or ventricle. In the other case dilatation of the right anterior sinus dissecting the interventricular septum was associated with an aneurysm of the left anterior sinus dissecting the free wall of the left ventricle.